Esch Jesse J, Kantoch Michal J
Department of Pediatrics, Stollery Children's Hospital, 2E1 WMC, 8440-112 Street, T6G 2R7 Edmonton, Alberta, Canada.
Pediatr Cardiol. 2008 Jan;29(1):210-3. doi: 10.1007/s00246-007-9076-0. Epub 2007 Sep 12.
Fluconazole is an antifungal medication that has been reported to cause prolongation of the QT interval and Torsades de Pointes (TdP) ventricular tachycardia in adults. We describe the case of an 11-year-old child treated with fluconazole who developed ventricular arrhythmia culminating in TdP. We discuss the possible roles played by genetic and environmental factors in this child's rhythm disturbances. After briefly summarizing similar cases from the adult literature, we outline the putative mechanism by which fluconazole may cause arrhythmia. This case should alert pediatricians to the possible risks of fluconazole use, especially in the presence of electrolyte abnormalities, diuretic use, therapy with other pro-arrhythmic agents, or suspicion of congenital Long-QT Syndrome.
氟康唑是一种抗真菌药物，据报道可导致成人QT间期延长和尖端扭转型室性心动过速（TdP）。我们描述了一名接受氟康唑治疗的11岁儿童发生室性心律失常并最终发展为TdP的病例。我们讨论了遗传和环境因素在该儿童心律失常中可能发挥的作用。在简要总结成人文献中的类似病例后，我们概述了氟康唑可能导致心律失常的推测机制。该病例应提醒儿科医生注意使用氟康唑可能存在的风险，尤其是在存在电解质异常、使用利尿剂、接受其他促心律失常药物治疗或怀疑患有先天性长QT综合征的情况下。
